Assessing and managing the risks of COVID-19 in the workplace: Applying industrial hygiene (IH)/occupational and environmental health and safety (OEHS) frameworks

Film production during the Covid-19 pandemic

BACKGROUND

The COVID-19 pandemic created unprecedented challenges for the film industry. Following a shutdown of productions, The Safe Way Forward document was developed to outline disease mitigation protocols. Despite this framework, many unanticipated scenarios arose during reopening of film production with the ongoing pandemic.

AIMS

To identify and document promising practices for mitigating COVID-19 transmission in the film industry that can inform future pandemics and other industries.

METHODS

We conducted a literature search to review research regarding COVID-19 disease mitigation efforts in the film industry. Through client-facing consultancy and consultant group meetings, we identified those factors most important for disease mitigation in the film industry and applicable to future pandemics and other industries. The Delphi Method enabled experts to review lessons learned as studio consultants during the COVID-19 pandemic; learnings were coded and analyzed for recurring themes.

RESULTS

We identified anxiety, mistrust, and poor communication as key contributors to decreased compliance with COVID-19 protocols. In response, our team demonstrated multi-specialty expertise, provided scientific explanations, and developed trust by listening empathetically and responding with clear, consistent messaging. These measures served to alleviate anxiety, improve compliance, and provide a safe return to production.

CONCLUSIONS

This study demonstrates the ability and agility of multi-disciplinary experts acting in the absence of clear guidance to support a safe return to film production. Workplace anxiety and non-compliance can be alleviated through effective communication by trusted experts. Lessons learned by our consultancy group can help protect workers across diverse industries in future pandemics.

Executive and hierarchical models for participatory response to health emergencies in the workplace: Lessons from COVID-19

Introduction

Workplaces are high-risk environments for epidemic transmission, and the COVID-19 pandemic has highlighted the significant impacts that health emergencies can have on both the healthcare system and the economy. This study presents executive and hierarchical models for participatory response to health emergencies in the workplace, with a focus on COVID-19.

Methods

The study was conducted in three phases. Content analysis of interviews with 101 stakeholders and national documents was used to identify key themes and dimensions for an executive model. A focus group discussion and review of international documents were then used to refine and expand the executive and hierarchical models. The alignment and trustworthiness of the final models, as well as feedback, were gathered from 117 informants working in various workplaces.

Results

The executive model highlighted that context understanding, management commitment, and participation play critical roles in developing tailored prevention and response plans, and adequate support is necessary for successful plan implementation. Monitoring and review processes should be established to ensure proper functioning. The hierarchical model emphasizes the need for collaborative efforts from various stakeholders to effectively implement pandemic prevention and participatory response plans.

Conclusion

Overall, the executive and hierarchical participatory models presented in this study provide a framework for effectively controlling pandemics and other health emergencies in the workplace, enhancing both health resilience and the sustainability of economic activities.

Learning from the Experience of the COVID-19 Pandemic: A New Paradigm for Occupational Biohazard Assessment and Management

The COVID-19 pandemic has affected workplaces in many different aspects. In this scenario, Occupational Physicians played a crucial role in assessing and managing the risk of SARS-CoV-2 infection and associated diseases to guarantee workers' health and the safety of workplaces. However, the pandemic experience has drawn attention to several critical issues in overall biohazard prevention and management strategies, originating from important knowledge gaps in our scientific understanding. An extensive analysis of the relevant hurdles that have emerged in our medical field can bring valuable lessons for the post pandemic future, not only in preparation for possible new pathogens with pandemic potential but also with principles and concepts applicable to managing all biological agents. In particular, a paradigm shift is needed to properly approach occupational diseases caused by infective agents, accurately define the "case", assess exposure and possible causal relationship with work appropriately, and effectively manage the specific risk through implementing appropriate preventive and protective measures. In this framework, the Occupational Physician should expand his contribution based on his unique expertise and specific competencies, confirming his role as the go-to consultant in all occupational health matters, but also in a multidisciplinary approach, considering different scientific expertise and evidence.

Control Banding and the Global Rise of Qualitative Risk Assessment Strategies

PURPOSE OF REVIEW

Control banding (CB) is a risk assessment strategy that has been applied globally to a variety of occupational hazards. This article describes how this method can be applied, recent developments in the CB literature, an example of how it is utilized for a large, diverse worksite, and where the future of CB is headed.

RECENT FINDINGS

Over the past several years, the applications of CB have widened significantly and have accordingly helped bolster the public and occupational safety, health, and hygiene (OSHH) professionals' understanding of occupational exposure to various hazards. The fields of workplace chemicals, nanomaterials, and airborne pathogens (i.e., COVID-19), specifically have seen remarkable increases in the development of CB tools. Extensive CB tool validation efforts have also lent increasing credibility to this alternative approach. CB is a simplified strategy of assessing occupational exposures and providing commensurate controls and solutions to reduce workplace risks. CB can be used as a primary or tiered risk assessment and risk management approach which can be utilized by both OSHH professionals and nonexperts alike to identify solutions for reducing work-related exposures. The need for health and safety expertise will continue to grow as technological advancements, environmental changes, and economic forces increase workplace hazard complexity, and CB will continue to be a useful tool for those performing risk assessments.

Insights into frontline healthcare workers' mental health amidst COVID-19 - Sources of workplace worries and coping strategies

Introduction

This study was aimed to measure the prevalence of depression, anxiety, and stress as well as to evaluate the associations of these mental disorders with sociodemographic factors, workplace worries, and coping strategies among frontline HCWs in Kuala Lumpur, Malaysia during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted in a tertiary teaching hospital in Kuala Lumpur, Malaysia. Sociodemographic data questionnaire, Depression, Anxiety, and Stress Scale 21, sources of workplace worries questionnaire, and Brief-COPE inventory were randomly distributed to frontline HCWs who worked at the medical, emergency, and anaesthesiology departments. Data were analyzed using Chi-square tests and multivariable linear regression analysis.

Results

A total of 137 frontline HCWs responded to the questionnaires. The prevalence of depression, anxiety, and stress was 69.3%, 77.4%, and 57.7%, respectively. None of the sociodemographic characteristics was associated with depression, anxiety, and stress. Depression was associated to all sources of workplace worries, except "fear of getting infected" (p = 0.089), while anxiety and stress were associated with all sources of workplace worries. Humour (β = 0.821), self-blame (β = 0.686), denial (β = 0.676), substance use (β = 0.835), and behavioural disengagement (β = 0.583) were positively correlated to depression. However, active coping (β = -0.648) and acceptance (β = -0.602) were negatively correlated to depression. On the other hand, active coping (β = 0.913), planning (β = 0.879), acceptance (β = 0.831), religion (β = 0.704), and self-distraction (β = 0.929) were positively correlated to stress. Only substance use (β = -0.417) was negatively correlated to stress. All coping strategies did not correlate to anxiety.

Conclusion

The high prevalence of depression, anxiety and stress is attributed by the various sources of workplace worries and the inappropriate coping strategies among the frontline HCWs. Measures that minimise workplace worries and inappropriate coping strategies must be implemented promptly.

SARS-CoV-2 genomic surveillance as an evidence-based infection control approach in an offshore petroleum employee population

BACKGROUND

Industrial hygienists (IH) in the oil and gas business instituted an extraordinary number of safety protocols to limit spread of SARS-CoV-2 onto offshore platforms in the Gulf of Mexico. We used genomic surveillance to provide actionable information concerning the efficacy of their efforts.

METHODS

Over 6 months, employees at a single company were serology and PCR tested during a 1-5 day predeployment quarantine and when postdeployment symptoms were reported. From each positive test (n = 49), SARS-CoV-2 genomes were sequenced. Phylogenetic analysis was used to investigate the epidemiology of transmissions.

RESULTS

Genomic surveillance confirmed 2 viral strains were infecting 18 offshore workers. Genomic data combined with epidemiological data suggested that a change in quarantine protocols contributed to these outbreaks. A pre-deployment outbreak involved a WHO variant of interest (Theta) that had infected 4 international workers. Two additional predeployment clusters of infections were identified.

CONCLUSIONS

Our findings support that IH quarantine/testing protocols limited viral transmissions, halted offshore outbreaks, and stopped the spread of a variant of interest. The study demonstrates how genomic data can be used to understand viral transmission dynamics in employee populations and evaluate safety protocols in the offshore oil and gas industry.

Occupational safety and health guidelines in relation to COVID‐19 risk, death risk, and case‐fatality proportion: An international, ecological study

Background

Coronavirus disease 2019 (COVID‐19) began in 2019 with several unknown factors. The World Health Organization (WHO) subsequently developed COVID‐19 occupational safety and health (OSH) guidelines to reduce occupational COVID‐19 transmission. Many countries also developed their own COVID‐19 OSH guidelines, but whether these guidelines included WHO's guidelines and whether including WHO's guidelines in countries' COVID‐19 OSH guidelines reduced COVID‐19 transmission is unknown.

Objectives

The objectives of our study were to (1) compare the COVID‐19 OSH guidelines of several countries to WHO's OSH guidelines, (2) estimate associations between characteristics of countries and their OSH guidelines and the number of WHO's OSH guidelines included in countries' OSH guidelines, and (3) estimate associations between WHO's OSH guidelines included in countries' OSH guidelines and COVID‐19 risk, death risk, and case‐fatality proportion.

Methods

This study represents international, ecological research of 36 countries from all six world health regions. Countries' COVID‐19 OSH guidelines were compared with WHO's OSH guidelines. Linear regression models adjusted for potential confounders were used to estimate associations of interest.

Results

The median number of WHO's 15 COVID‐19 OSH guidelines included in countries' COVID‐19 OSH guidelines was eight. Countries' COVID‐19 OSH guidelines focused on workers included significantly more of WHO's COVID‐19 OSH guidelines than countries' COVID‐19 OSH guidelines focused on general populations. Including “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment” in countries' COVID‐19 OSH guidelines were significantly related to decreased COVID‐19 risk, death risk, and/or case‐fatality proportion.

Conclusions

Countries' COVID‐19 OSH guidelines should include WHO's guidelines, focus on workers, and include “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment.”

COVID-19 in the Workplace in Indonesia

Coronavirus Disease 2019 (COVID-19) has been declared a pandemic because of its worldwide spread. The COVID-19 pandemic does not only impact public health but also the operations of businesses and workers’ safety in their workplace. The objectives of this study were to provide a broad perspective of COVID-19 prevention and control implementation in industries, investigate barriers and challenges as well as drivers in implementing COVID-19 prevention and control, and provide key recommendations to the policy makers regarding COVID-19 prevention and control in industries. This study was conducted through online interviews with selected organizations in various industries which were selected by the granting body, including agriculture and animal husbandry; construction; manufacturing; and logistic and goods transportation. It also involved policy makers from government agencies including the Ministry of Manpower, Ministry of Health, Indonesian Safety and Health Council, International Labor Organization, and Indonesian COVID-19 Task Force. The participants of this study were chosen using convenience sampling. The findings of this study indicate that health protocols are implemented to varying degrees in companies, both within and across the sectors, and that drivers to comply with the Health Protocols include compliance, business continuity, and top management commitment. The significant barriers and challenges include a perceived lack of clear direction from the government, rapid changes in directives’, poor worker awareness, and limited organizational resources. The key recommendations to the policy maker include harmonization of the guidelines and legislation, additional schemes to provide funding in the COVID-19 prevention and control implementation, as well as facilitate the ongoing education of the general working public.

COVID-19 infection and the broader impacts of the pandemic on healthcare workers

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease or COVID-19 pandemic is associated with more than 230 million cases and has challenged healthcare systems globally. Many healthcare workers (HCWs) have acquired the infection, often through their workplace, with a significant number dying. The epidemiology of COVID-19 infection in HCWs continues to be explored, with manifold exposure risks identified, leading to COVID-19 being recognised as an occupational disease for HCWs. The physical illness due to COVID-19 in HCWs is similar to the general population, with some HCWs experiencing a long-term illness, which may impact their ability to return to work. HCWs have also been affected by the immense workplace and psychosocial disruption caused by the pandemic. The impacts on the psychological well-being of HCWs globally have been profound, with high prevalence estimates for mental health symptoms, including emotional exhaustion. Globally, governments, healthcare organisations and employers have key responsibilities, including: to be better prepared for crises with comprehensive disaster response management plans, and to protect and preserve the health workforce from the physical and psychological impacts of the pandemic. While prioritising HCWs in vaccine rollouts globally has been critical, managing exposures and outbreaks occurring in healthcare settings remains challenging and continues to lead to substantial disruption to the health workforce. Safeguarding healthcare workforces during crises is critical as we move forward on the new path of 'COVID normal'.

Occupational management of healthcare workers exposed to COVID-19

BACKGROUND

The year 2020 was marked by the new coronavirus pandemic, resulting in millions of cases and deaths, placing healthcare workers at high risk of infection.

AIMS

The aim of this study was to describe the role of an occupational health service during coronavirus disease 2019 pandemic in an oncologic hospital and characterize the most likely sources of viral infection.

METHODS

The information of all healthcare workers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from 11 March to 15 December 2020 was collected through an epidemiological survey conducted during contact tracing. The data extracted included gender, age, comorbidities, occupational group, source of infection, clinical presentation, duration of the disease, need for hospitalization and persistent or late symptoms after disease or upon returning to work.

RESULTS

Out of a total of 2300 workers, 157 were infected, consisting of nurses (36%), nurse assistants (33%) and diagnostic and therapeutic professionals (10%). Physicians and administrative staff accounted for 8% each. The most frequently reported source of infection was occupational (43%), owing to worker-to-worker transmission (45%) and patient-to-worker transmission (36%). The most frequent moments of infection perceived corresponded to the removal of protective equipment during meals and moments of rest in the staff and changing rooms.

CONCLUSIONS

The study revealed that occupational transmission from patients and colleagues might be an important source of SARS-CoV-2 infection in healthcare workers. Spread between colleagues accounted for 45% of the occupational source infections reported. Implementing physical distancing measures and limiting the number of people in changing and rest rooms could significantly reduce infection and related absenteeism.

Role and Tasks of the Occupational Physician during the COVID-19 Pandemic

Background and Objectives: The first clusters of SARS-CoV-2 infection were identified in an occupational setting, and to date, a significant portion of the cases may result from occupational exposure; thus, COVID-19 should also be considered a new occupational risk that both directly and indirectly impacts the health of workers. Given the significance of occupational-exposure-related infections and deaths, this study aims to assess the roles and tasks of occupational physicians (OPs) in countering the spread of the infection. Indeed, despite the OP's centrality in risk management in the workplace, its activity in the current epidemic context has rarely been mentioned. Materials and Methods: Three different databases (PubMed, Google Scholar, and Embase) were questioned using the main keywords "COVID-19" and "SARS-CoV-2" that were crossed, according to different needs, with the terms "occupational medicine", "occupational physician", "workplace", and "risk assessment" using, when possible, the MeSH database research. Additionally, a systematic research of the regulatory changes of workplaces health surveillance was performed on reference sites of international, European, and Italian authorities. Results: Fundamental tasks and duties of OPs in the current COVID-19 outbreak are highlighted by examining their clinical activity and technical action. A risk assessment and management workflow is proposed, and medico-legal implications in case of infection at work are also discussed in the light of recent regulatory changes that clearly attribute to OPs an important role in safeguarding public health. Conclusion: The proposed approach can provide new instruments to contrast the spread of the infection as part of a comprehensive system response to the current pandemic, for which OPs are called to assume full responsibility.

Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study

Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.

Susceptibility to Coronavirus (COVID-19) in Occupational Settings: The Complex Interplay between Individual and Workplace Factors

In the current coronavirus (COVID-19) pandemic, the definition of risk factors for susceptibility to adverse outcomes seems essential to support public and occupational health policies. Some specific issues need to be addressed to understand vulnerability in occupational settings. Among these, individual factors, e.g., age, sex, and preexisting comorbidities (hypertension, cardiovascular diseases, diabetes, obesity, cancer), that can predispose individuals to more severe outcomes and post-COVID-19 symptoms that may represent conditions of acquired susceptibility, possibly impacting the return to-and fitness for-work. Additionally, the risk of contracting COVID-19 through work should be addressed, considering the probability of being in contact with infected people, physical proximity to others, and social aggregation during work. Occupational health settings may represent appropriate scenarios for the early identification of vulnerable subjects, with the final aim to guide risk assessment and management procedures. These should include the systematic surveillance of work-related risk factors, collective preventive policies, stringent actions for specific groups of workers, decisions on occupational placement of employees, and health promotion activities. Concerted actions of general practitioners, hospital specialists, occupational physicians, and all the stakeholders involved in the occupational health and safety management should be focused on planning suitable preventive measures for susceptible subjects.